Martine Kruijtbosch

57 Pro f es s i ona l va l ues wi t h i n mo ra l d i l emmas TABLE 2: Moral dilemmas 1 and 2 Moral dilemma 1 (PHARM-1239) A patient had been dispensed 10 tablets of ibuprofen 600mg after a dental procedure the previous day. The patient returns for a refill and explains that she experienced only one hour’s pain relief after one dose and had already finished her tablets. The pharmacist was uncertain on whether to dispense. Customised professional core values: ‘ I wanted to help her get rid of her pain.’ Commitment to the patient’s well- being ‘On the other hand, I suspected an infection as the effect of the ibuprofen should be longer than one hour. Hence, I referred her to the physician. ’ Pharmaceutical expertise ‘She didn’t want this advice and angrily persisted in demanding ibuprofen.’ Reliable and caring ( maintaining a relationship of trust with the patient ) Moral dilemma 2 (PHARM-244) A 50-year-old woman is overusing the laxative bisacodyl. She buys several boxes per week. The pharmacist had tried to discuss the overuse and the possible harm this could cause several times. The woman was never interested in discussing it. Hence, the pharmacist decided to no longer dispense the medicine and referred her to her physician to obtain a prescription. The next day she presented a prescription. Customised professional core values: ‘ It is my task to inform the patient about the detrimental effects of overusing this drug. ’ Commitment to the patient’s well-being ( facilitating shared decision-making ) Pharmaceutical expertise ‘ Should I inform her physician about her overuse?’ Reliable and caring ( respecting patient’s confidentiality )